Tackling yellow fever in the north of Uganda

Health officials in Uganda have launched a yellow fever vaccination drive in the north where an outbreak of the disease has caused 53 deaths and 224 infections in 10 districts since late 2010.

Almost a million people are expected to be vaccinated in the campaign, launched by Health Minister Richard Nduhura on 23 January.

The outbreak - affecting all age groups - was first reported in Abim district in Karamoja sub-region on 16 November 2010. Cases have been reported from several northern districts.

Local leaders told IRIN they feared there may not be sufficient medicine as people were coming from far and wide to be inoculated.

"We have people coming from as far as Southern Sudan for the vaccination; it is a challenge for us," John Bosco Ogwok, Kitgum district local council chairman, said.

Vaccination points, Ogwok said, especially those near the border with Southern Sudan, have registered large numbers of Sudanese, while Ugandans from neighbouring districts such as Gulu and Lira have also turned up for vaccination.

Grace Ogwang, a nursing officer in Kitgum district coordinating outpost vaccination points, told IRIN that health officials were vaccinating everyone who turned up.

"Our ethics in the practice of medicine is non-discrimination; whether you are from Kitgum or not, we don't discriminate," Ogwang said. "We are vaccinating everybody coming to the vaccination point, so long as you are above six months of age."

Kitgum is one of the five districts where the first phase of vaccination is taking place in northern Uganda. The others are Pader, Lamwo, Agago and Abim.

Health Minister Nduhura said the remaining districts in the north would begin the programme during a second phase whose start date depended on resolving funding issues.

According to World Health Organization (WHO), an estimated 200 000 cases of yellow fever occur every year, causing 30,000 deaths. The virus is endemic in 45 tropical countries in Africa and Latin America, with a combined population of more than 900 million.

Risk

In Africa, WHO estimates 508 million people in 32 countries (including Uganda) are at risk. The number of yellow fever cases has increased over the past two decades due to declining population immunity to infection, deforestation, urbanization, population movements and climate change.

In the case of Uganda, the genomic sequencing of the virus strain responsible for the current yellow fever outbreak is 98 percent identical to the East African Couma-Ethiopia genotype, according to a WHO brief. This is an indication that the virus has been circulating in the region.

Kenya, the Democratic Republic of Congo and Sudan reported yellow fever outbreaks in 1992-1993. A recent outbreak occurred in Sudan in 2003.

Source: IRIN News